Open versus closed method of pneumoperitoneum creation in laparoscopic surgery: A comparative study

Abstract

Aim: A comparative study of the open versus closed method of pneumoperitoneum creation in laparoscopic surgery. Methods: This comparative study conducted in the Department of Surgery. 80 patients of either sex were selected who undergone operative procedure for laparoscopy surgery were included in this study. All patients undergoing elective laparoscopic surgery and hemodynamically stable patients. Results: Technical difficulties like multiple attempts, gas leak at port site and port site bleeding are more in open method than in closed method, which is attributed to larger size of incision in open method, Furthermore, a significant higher incidence of such minor complications is found in case of BMI >25 p=-5.33 (p<0.05) at confidence level of 95%). Duration for pneumoperitoneum creation in open method group is shorter as compared to closed method group for pneumoperitoneum creation in laparoscopic surgery; p value is 0 (p<0.05) at confidence level of 95%). Minor technical difficulties like multiple attempts (p=0.039), gas leak at port site (p=0.037), and minor complications like port site bleeding are more with open method. While one case pre peritoneal insufflation is noted in case of closed method. Herep<0.05 in most of the cases. Hence, it is statistically significant. Conclusion: We can conclude that both methods i.e. open and closed methods of creating pneumoperitoneum in laparoscopic surgery are safe to perform. The open technique has slightly more incidence of minor complications due to large incision size but has advantage of lesser duration needed for procedure.